Direct Repair of the Superior Band of Bigelow’s Ligament After Hip Arthroplasty: a Surgical Technique

Liu, Joseph K.; McLawhorn, Alexander S.; Christ, Alexander B.; Dzenis, Peteris; Healey, John H.

doi:10.1007/s11420-015-9485-1

Cited by 3 publications

(4 citation statements)

References 20 publications

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“…In case of an iatrogenic lesion during total hip arthroplasty, using a posterolateral approach, Liu et al described a simple, rational technique for reinforcing the SBILFL. 30 A meticulous exposure of the hip capsule is performed during the posterolateral surgical approach, after which a trapezoidal capsulotomy is performed. After the insertion of the arthroplasty implants, retractors are placed to expose the superior capsule.…”

Section: Resultsmentioning

confidence: 99%

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The role of the iliofemoral ligament as a stabilizer of the hip joint

et al. 2021

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The purpose of this systematic literature review is to analyse the role of the iliofemoral ligament (ILFL) as a hip joint stabilizer in the current literature. A total of 26 articles were included in the review. The ILFL is the largest hip ligament consisting of two distinct arms and is highly variable, both in its location and overall size, and plays a primary role in hip stability; in the case of hip dislocation, the iliofemoral ligament tear does not heal, resulting in a persistent anterior capsule defect. Clinically, the ILFL is felt to limit external rotation in flexion and both internal and external rotation in extension. The abduction–hyperextension–external rotation (AB-HEER) test is overall the most accurate test to detect ILFL lesions. Injuries of the ILFL could be iatrogenic or a consequence of traumatic hip instability, and can be accurately studied with magnetic resonance imaging. Different arthroscopic and open techniques have been described in order to preserve the ILFL during surgery and, in case of lesions, several procedures with good to excellent results have been reported in the existing literature. The current systematic review, focusing only on the ILFL of the hip, summarizes the existing knowledge on anatomy, imaging and function and contributes to the further understanding of the ILFL, confirming its key role in anterior hip stability. Future studies will have to develop clinical tests to evaluate the functionality and stability of the ILFL. Cite this article: EFORT Open Rev 2021;6:545-555. DOI: 10.1302/2058-5241.6.200112

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Section: Resultsmentioning

confidence: 99%

“…Prior to the transosseous repair of the capsule and short external rotator tendons, the proximal limb of the capsulotomy is reapproximated anatomically and repaired with non-absorbable sutures. 30 …”

Section: Resultsmentioning

confidence: 99%

The role of the iliofemoral ligament as a stabilizer of the hip joint

et al. 2021

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“…Our medial wall approach further removed bias and confounding factors from these data. It avoided using a specific incision or repair technique, for which there are many in routine clinical use [1][2][3][4][5][6][7][8][9][10][11][12] , and it allowed for a repeated-measures study design that reduced the effects of interspecimen and procedural variability. The resulting baseline data on the effects of head size and neck length can therefore be interpreted with respect to any surgical approach.…”

Section: Neck Lengthmentioning

confidence: 99%

“…any surgical approaches for total hip arthroplasty (THA) aim to maximize capsule preservation [1][2][3][4][5][6][7][8][9][10] and/or repair capsule incisions [1][2][3][4][5][6][7][8][9] , while others excise the capsule to improve exposure, as it is considered of little consequence 11,12 . Capsule preservation and repair can help to lower dislocation rates 6,7,10,[13][14][15][16][17][18] , and may also maintain the defenses of the native hip against hypermobility, impingement, subluxation, and edge-loading [19][20][21][22] .…”

mentioning

confidence: 99%

Capsular Ligament Function After Total Hip Arthroplasty

Arkel¹,

Ng²,

Muirhead-Allwood³

et al. 2018

The Journal of Bone and Joint Surgery

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Background: The hip joint capsule passively restrains extreme range of motion, protecting the native hip against impingement, dislocation, and edge-loading. We hypothesized that following total hip arthroplasty (THA), the reduced femoral head size impairs this protective biomechanical function. Methods: In cadavers, THA was performed through the acetabular medial wall, preserving the entire capsule, and avoiding the targeting of a particular surgical approach. Eight hips were examined. Capsular function was measured by rotating the hip in 5 positions. Three head sizes (28, 32, and 36 mm) with 3 neck lengths (anatomical 0, +5, and +10 mm) were compared. Results: Internal and external rotation range of motion increased following THA, indicating late engagement of the capsule and reduced biomechanical function (p < 0.05). Internal rotation was affected more than external. Increasing neck length reduced this hypermobility, while too much lengthening caused nonphysiological restriction of external rotation. Larger head sizes only slightly reduced hypermobility. Conclusions: Following THA, the capsular ligaments were unable to wrap around the reduced-diameter femoral head to restrain extreme range of motion. The posterior capsule was the most affected, indicating that native posterior capsule preservation is not advantageous, at least in the short term. Insufficient neck length could cause capsular dysfunction even if native ligament anatomy is preserved, while increased neck length could overtighten the anterior capsule. Clinical Relevance: Increased understanding of soft-tissue balancing following THA could help to prevent instability and improve early function. This study illustrates how head size and neck length influence the biomechanical function of the hip capsule in the early postoperative period.

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